Why UPC

The UPC Ratio is a simple test that measures how much protein is being lost through the kidneys, and determines if the loss poses a health risk for the pet.

Proteinuria is an important concern given its correlation with poor patient outcome. The UPC Ratio has shown a significant correlation with the morbidity of the patient—the higher the UPC ratio value, the worse the prognosis.

The UPC Ratio is the best test available for:

Detecting proteinuria and measuring persistence and magnitude

Guiding clinical decisions and monitoring response to therapy

UPC Algorithm

Once an animal has been diagnosed with CKD and staged according to IRIS guidelines, the next step is to substage the dog or cat based on proteinuria and hypertension.

Understanding UPC

A CKD patient with good urine concentrating ability:

A CKD patient with loss of concentrating urine ability:

The degree of proteinuria when the animal is first diagnosed with renal disease is helpful in predicting survival time, according to our studies. It’s a gradation; the lower the protein in the urine, the longer the cat is going to survive.

Synopses from the scientific literature

2004 ACVIM Forum Consensus Statement

A great deal of attention has been given to the role of proteinuria in the diagnosis of renal disease.

The leading veterinary experts in Nephrology developed the ACVIM Forum Consensus Statement (Small Animal) on July 28, 2004: “Assessment and Management of Proteinuria in Dogs and Cats”. This 18 page document highlights the most recent research on urine protein and reviews the definition and classification of proteinuria, how it is best to detected and assessed, what the implications are of increased persistent renal proteinuria, when and how to test for proteinuria and how the veterinarian should respond clinically to a finding of proteinuria.

Relation of Survival Time and Urinary Protein Excretion in Cats with Renal Failure and/or Hypertension

The degree of proteinuria is predictive of the survival times in cats with CRF.

In addition to monitoring proteinuria and evaluating the response to therapy, the UPC ratio can be used to determine the approximate survival time of the cat. The higher the level of proteinuria, the shorter the survival time for a given feline patient.

Proteinuria and Renal Disease – A roundtable discussion

This Roundtable is a discussion by the world’s leading experts on renal disease and practitioners discussing kidney disease and proteinuria.

It includes useful information about the prevalence of kidney disease in dogs and cats as well as practical information about diagnosing and treating and monitoring kidney disease in the canine and feline patient.

UPC FAQs

The UPC Ratio is a simple test that measures how much protein is being lost through the kidneys, and determines if the loss poses a health risk for the pet. The test involves measuring the amount of protein and creatinine in a urine sample, and mathematically dividing the protein value by the creatinine value.

Creatinine is a by-product of muscle metabolism. Creatinine is excreted in urine at an approximately constant rate, which means it can be used as a standard for comparison for other substances that are also excreted in the urine.

For this test, urine creatinine levels are used to standardize urine protein levels for fluctuations in urine concentration driven by the patient’s level of hydration.

Transient loss of a small amount of protein through the kidneys may not be critical if the kidneys are otherwise working well and producing concentrated urine. However, if kidney function is compromised and the kidneys are producing dilute urine, then even small amounts of urinary protein loss may be abnormal and should be investigated. Substantial and/or persistent protein loss through the kidneys is a concern because it means the kidneys are not working properly. It is also worrisome because the body is losing protein, which is a precious substance needed for long-term health and well-being.

No. Protein can be present in urine if there is inflammation or bleeding anywhere in the urinary system. Protein that comes from inflammation or bleeding is not as worrisome, because the urinary protein loss will stop once the underlying problem is treated or corrected. This is why a urine sediment exam is necessary in conjunction with a UPC Ratio; clean urine sediment is needed to ensure that any subsequent protein detected is of kidney origin.

No. The UPC ratio should be performed only on urine that is free of blood and inflammatory cells. A complete urinalysis and sediment evaluation should be completed to determine if the sample is suitable for the UPC Ratio test. The presence of blood and inflammation in urine may give a falsely high result for the UPC Ratio, suggesting there is kidney disease when none is actually present.